Provider Demographics
NPI:1891026597
Name:ANDERSON, ERIN TANIA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:TANIA
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15838 HIGHWAY K42
Mailing Address - Street 2:
Mailing Address - City:WHITING
Mailing Address - State:IA
Mailing Address - Zip Code:51063-8745
Mailing Address - Country:US
Mailing Address - Phone:402-637-6659
Mailing Address - Fax:
Practice Address - Street 1:15838 HIGHWAY K42
Practice Address - Street 2:
Practice Address - City:WHITING
Practice Address - State:IA
Practice Address - Zip Code:51063-8745
Practice Address - Country:US
Practice Address - Phone:402-637-6659
Practice Address - Fax:855-848-2902
Is Sole Proprietor?:No
Enumeration Date:2010-01-19
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA062771041C0700X
NE13311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical